Medical Services in New Zealand and The Pacific
I: Organisation of 3 NZ Division Medical Units in New Zealand and Functioning in New Caledonia
I: Organisation of 3 NZ Division Medical Units in New Zealand and Functioning in New Caledonia
The following medical units returned to New Zealand from Fiji in July 1942: Base Hospital (from Tamavua); Base Hospital (from Namaka); 7 Field Ambulance; 22 Field Ambulance; Hygiene Section (from Samambula); Hygiene Section (from Namaka); ADMS with Medical Stores Section. After a period of leave the members of these units reassembled at Papakura and the reorganisation of the Division began.
The two hospitals were amalgamated to form 4 NZ General Hospital. Equipment and personnel for a general hospital were made up from the constituent units and Army Headquarters supplied deficiencies. This was the first time a general hospital had been equipped in New Zealand, and many items had to be improvised or manufactured locally; some were not available when the unit went to New Caledonia. The two field ambulances (7 and 22) were light field ambulances. These were built up to full field ambulance war establishment in both equipment and personnel.
The two hygiene sections were formed into 6 Field Hygiene Section. The Medical Stores Section was formed into an Advanced Depot of Medical Stores and brought up to war establishment in both equipment and personnel.
New units formed were two Field Surgical Units, which were complete in equipment and personnel, and whose personnel were drawn mainly from the experienced orderlies of 4 NZ General Hospital; a Malaria Control Unit – again complete in personnel and equipment, its officers being a medical officer, an entomologist and an engineer officer; a Field Transfusion Unit complete with equipment and refrigerator van; an Optician Unit and a Motor Ambulance Convoy. (Additional units formed and equipped in New Zealand during 1943 and sent forward to join the Division were 2 NZ CCS, 2 NZ Convalescent Depot, and 24 NZ Field Ambulance.)
The main points of training in New Zealand from July to December 1942 were:
Route marching. All units were expected to attain a standard of 20 miles a day with ease.
Medical units were given the opportunity of sending orderlies to Auckland and Waikato hospitals for training in hospital and theatre work. This training extended over a period of six weeks in each case.
Field ambulances had small 20-bed Camp Reception Stations in their brigade areas. These CRSs held minor sick but evacuated the bulk of the cases to public hospital.
Fourth NZ General Hospital opened a small hospital in Hamilton at the Hamilton West School.
Manoeuvres – a full-scale exercise lasting ten days was held in the Kaimai Range late in October. The medical units taking part were 7 and 22 Field Ambulances. The manoeuvre took place in country similar to that which it was anticipated would be encountered in the Pacific. The manoeuvres gave the opportunity to gain experience in field hygiene away from the established camps.
Special emphasis was laid on field hygiene and malaria control and also on evacuation in the field. (A special course in hygiene was held for senior combatant officers.)
The ADMS left for New Caledonia on 7 November to make preliminary medical arrangements and the medical units proceeded overseas in two flights in December.
On 1 December there embarked 22 Field Ambulance, advanced party of 4 General Hospital, 1 Field Surgical Unit, 6 Field Hygiene Section and 1 Malaria Control Unit.
On 28 December the balance of the units embarked – 7 Field Ambulance, 4 General Hospital, 2 Field Surgical Unit, 4 MAC and Advanced Depot of Medical Stores.
New Caledonia – General Situation
As later events were to prove, the turning point in the war in the Pacific had been reached in 1942 when on 4 June the United States Fleet dealt a crushing blow against the Japanese Fleet at the Battle of Midway. From that stage the Allies turned to the offensive. In August 1942 Americans landed on the Japanese-held island of Guadalcanal in the Solomon Islands, 1000 miles to the north of page 23 page 24 New Caledonia. The outcome of operations on Guadalcanal was still being awaited when 3 NZ Division reached New Caledonia in December 1942 and January 1943. Complete control of the Solomons was considered an essential pre-requisite for Japanese offensive operations against the New Hebrides, New Caledonia and Fiji. The issue lay between the eventual domination of the Solomons from Allied airfields and the possibility of the Japanese landing artillery, putting Henderson Field on Guadalcanal out of action, and nullifying the Allied strategical advantage.
In New Caledonia 3 NZ Division came under the operational command of the United States forces. The whole island was divided for purposes of defence into three sectors. The Fighting French forces held the southern sector, including the main port of Nouméa, 43 US Division the central sector, and the New Zealanders were allotted the northern sector, where particular attention was to be paid to the defence of supplies and airfields at Plaine des Gaiacs and Koumac and the installations at Pam and Gomen. Plans for the defence of other points and airfields were to be prepared and a continuous watch kept on both coastlines.
The New Zealanders replaced American troops required for fighting on Guadalcanal, and when that island was conquered in February 1943 they entered upon a garrison role and underwent further training while the Division was being built up. But the completion and concentration of 2 NZEF (IP) in New Caledonia took another six months. Lack of shipping was the main difficulty, though there were problems of manpower in New Zealand. The furlough draft from the Middle East was a major complication. For months the Division was deficient in equipment as well as in troops, and its participation with the Americans in the Solomon Islands campaign was delayed.
Dispositions of Medical Units
When 3 Division moved into New Caledonia it occupied areas extending from the north of the island to the south of Bourail. Fourteenth Brigade, with headquarters on the Taom River, was in the northern section; 8 Brigade was in the central section with headquarters in the Népoui valley and within easy reach of the airfield at Plaine des Gaiacs; 15 Brigade was in the southern section, with headquarters at Néméara. (When 43 US Division moved from New Caledonia north into the Solomons combat zone in February 1943, 8 Brigade took over the central sector of the island at Bouloupari. This necessitated an extension of brigade sections and duties until the Division extended over three-quarters of New Caledonia.)
The New Zealand units were scattered over a wide area in which road communications were bad, so ADMS 3 NZ Division arranged page 25 for each field ambulance to establish one or more dressing stations as required to serve their respective brigade groups and for the main dressing station to provide the fullest possible treatment. Field surgical units were attached to the two field ambulances.
When they arrived in New Caledonia in December 1942 and January 1943, the New Zealand medical units were disposed in the following locations:
|ADMS 3 NZ Division||Moindah|
|6 Field Hygiene Section||Moindah|
|1 Malaria Control Unit||Base-Bourail|
|22 Field Ambulance||Tinipp (near Ouaco) – 14 Brigade|
|1 Field Surgical Unit (att 22 Fd Amb)||Tinipp|
|7 Field Ambulance||Népoui valley – 8 Brigade|
|7 Field Ambulance (B Coy)||Néméara-15 Brigade|
|2 Field Surgical Unit (att 7 Fd Amb)||Népoui valley|
|4 General Hospital||Boguen valley|
|Advanced Depot Medical Stores||Boguen valley|
|1 Optician Unit||Boguen valley|
|1 Field Transfusion Unit||Attached to Veterinary Depot, US Forces|
In addition there were 14 RMOs with combatant units and at base camp and at the Base Detachment at the port of Nouméa.
The Base Camp Reception Hospital came into being in the three months from January 1943, when the disposition of units in New Caledonia proved the necessity for a hospital in the base area to admit the lighter sick and also patients with venereal disease. The OC of the unit was also SMO of the base area. The unit had an operating theatre. It admitted patients from April 1943 to August 1944.
The climate of New Caledonia was sub-tropical and healthy. During the summer months high temperatures were reached but, for the most part, humidity was low. The nights were comparatively cool, facilitating sleep. The average rainfall was 40 inches a year, half of which fell during the ‘rainy season’ from January to April. The climate was less trying than that of Fiji, which was farther north, and acclimatisation was not difficult for the average New Zealander.
Hookworm was widespread among the population of the island, as in all Pacific islands. A survey of school-children had revealed that over 50 per cent were infected with either ankylostomiasis or page 26 trichocephaliasis. Dysentery, both amoebic and bacillary, was endemic. Dengue fever was prevalent in the towns. Typhoid fever occurred among the native and civilian population, while tuberculosis was common. Leprosy was endemic and the thousand cases among the local population were not strictly segregated but continued to live with their families. Sporadic cases of plague occurred, the rat flea being common. Dermatitis of all sorts and impetigo were widespread, but septic sores, a common cause of disability in Fiji, were not prevalent. Cases of filariasis, dengue fever and yaws also occurred. Venereal disease, especially gonorrhoea, was fairly common among the local population.
There was no malaria as the anopheles mosquito was not present on the island. Other mosquitoes, however, were relatively common, especially during the rainy season. (In most camp areas the prevailing species, aedes vigilax, a salt-marsh breeder, proved troublesome in the wet months, January to April. At their peak periods the mosquitoes interfered considerably with work and morale, while they were associated with outbreaks of dengue fever in March.)
Health of Troops
Special instructions on hygiene and sanitation were issued to the troops and steps were taken to safeguard them against endemic disease. In the early weeks following the Division's arrival there were many cases of diarrhoea and an outbreak of gastro-enteritis affecting seventy men, but no serious outbreaks of other infectious disease. The incidence of diarrhoea decreased as the troops became acclimatised, just as had happened with the American troops. Skin diseases and ear and upper respiratory infections accounted for much of the sickness.
Under the supervision of the Divisional Hygiene Officer and personnel of 6 Field Hygiene Section the general standard of field sanitation was raised and measures were taken to combat the flies. Difficulties were experienced at first as timber was scarce and no fly-proofing materials were available, making it impossible to provide fly-proofing for kitchens and ration stores, while supplies of disinfectants were on a low scale. Latrines were of the deep-trench box-cover type. Basins of disinfectant were placed outside them. Funnel urinals were formed with pipes of bamboo leading into a pit filled with stones. Refuse at base camp was kept in fly-proof drums and disposed of twice daily to a pig farmer. Refuse in the form of tins was burnt daily, the tins then being crushed and buried. Sullage water was disposed of by soak-hole methods or by means of an evaporation pit.
Two units accompanied 3 Division: the Base Hygiene Unit and 6 NZ Field Hygiene Section.
The base unit consisted of 1 officer, 6 NCOs and 10 men. Its role was a stationary one in New Caledonia and it was concerned with established and well-built camps. The Field Hygiene Section consisted of 1 officer, 4 NCOs and 10 men. The officer was a medical officer and the large percentage of the men were tradesmen (plumbers, carpenters, etc.) and there were four ASC personnel attached.
This latter unit was attached to the Division and was an integral part of it. It was mainly used near Divisional Headquarters and detachments of it, usually under a senior NCO, were associated with the brigades. In the brigades the detachments lived with the field ambulances. During the training period in New Caledonia 6 Field Hygiene Section was primarily concerned with training its own personnel and sanitary personnel and officers and men in outside units. Courses were run for sanitary personnel and lectures given in their own camps to officers and NCOs. The workshop was busy preparing sample latrines, collapsible safes, grease traps, fly traps, etc., from which units could copy their own. A portable blanket fumigator was in use and was taken to units regularly. All this time the routine camp inspections, water inspections and hygiene duties were carried out by the unit.
In the selection of camp sites proximity to a stream was considered of first importance to provide for ablution and bathing facilities. Bacteriological examination of samples of water taken from various streams from which drinking water was drawn for the use of units and camps showed in almost every case evidence of some degree of contamination. Strict control of measures adopted for the purification of drinking water was therefore carried out. The water carts supplied from New Zealand were found to be unsatisfactory in many respects. A plan was therefore developed for the establishment of water points, thus reducing the employment of water carts to a minimum. At the points the water was pumped into canvas tanks, then chlorinated and filtered and stored in camp containers.
Rations were issued according to the American scale and were mostly tinned foods. This provided a varied diet, sufficient in amount and well balanced, but the troops found it irksome and unpalatable page 28 and food value was lost in items that were not eaten. The diet was rather different from that in New Zealand, and many men missed the more bulky meal of bread and meat, but as the cooks became accuWH2PMe to the new type of rations they provided more attractive meals. Rations as supplied in some cases proved unfit for consumption and it was necessary to condemn large quantities, especially of salted beef and pork. A special administrative instruction was therefore issued on the inspection of foods. Hospital rations on a special scale were provided for patients.
At first 90 per cent of food came out of tins, and among a proportion of New Zealand troops, particularly some of the staff of 4 General Hospital, a nutritional anaemia (macrocytic) was detected, moderate but definite in degree. This was, in part, thought to be due to a deficiency in the ration, which did not contain any meat comparable to bully beef, and, in part, to the disinclination of troops to eat certain of the American canned foods. The anaemia did not respond to iron, but improved on both liver extract and yeast extract (marmite), and it was assumed to be due to lack of the so-called extrinsic factor. With the addition of fresh meat, fresh butter, fresh fruit and vegetables to the ration there was no further evidence of the trouble. During March 1943 supplies of frozen meat and butter began to come forward from New Zealand, and then fresh vegetables and fruit, some from Australia.
A new appointment to the staff of 4 General Hospital in the person of a messing officer made possible the better balancing and arranging of the hospital diets and facilitated the purchasing of certain local fruits and vegetables, and, for the patients, of eggs, fish and fresh milk. When additional trained cooks arrived from New Zealand, the standard of messing at the hospital became as high as in the best camps in New Zealand.
Some units obtained leases of local land and set about growing their own fresh vegetables to offset the predominance of canned foods, while canteen purchases and issues and parcels from New Zealand provided supplementary items.
Work of Field Ambulances
The field ambulances had to provide more or less complete medical services for their respective brigades and to that end established small hospitals. Soon after its arrival in December 22 Field Ambulance was running a hospital near Ouaco, at the foot of Mount Ouazangou and near the Tinipp River – about 200 miles from Nouméa and about 100 miles from the New Zealand base in the Bourail area. With 1 FSU attached and with the posting of seven sisters of the NZANS in January, the hospital was well page 29 staffed. At first only tents were used for the hospital but a building was erected in February; it was 94 feet long and was divided into three wards with a total capacity of sixty beds. The engineers assisted with a compressor to dig post-holes in the rocky site, the men of the unit provided timber gangs and erected the structure, while native labour was employed to thatch a roof with niaouli bark. The building had a concrete floor. Other medical units also built these native-style huts or bures: 7 Field Ambulance at Népoui and Bouloupari, Base Camp Reception Hospital at Bourail. They were used for messrooms, cookhouses and stores as well as for wards. Nursing sisters were also attached to the hospitals run by 7 Field Ambulance at Bouloupari and by A Company 22 Field Ambulance at Népoui after 7 Field Ambulance had left the latter site. The sisters, in addition to their nursing duties, trained nursing orderlies, and this instruction proved of great value when the units moved forward to the Solomon Islands. X-ray examinations were carried out by 109 US Station Hospital before X-ray equipment was functioning at 4 General Hospital.
The field ambulances were to some extent deficient in equipment. Tools were insufficient for the necessary construction work, as were timber, wire and tarpaulins. Twenty-second Field Ambulance reported that its lighting equipment included two old 1910-pattern acetylene lamps without carbide, and 1 FSU likewise had one of these lamps which had arrived in New Zealand in 1918. Mosquito nets were of wide-mesh gauze which did not restrict the entry of unfed or small mosquitoes, though they did prevent their exit after they were swollen with human blood.
As 4 General Hospital was not completed until early March 1943 the field ambulance and reception hospitals were called upon to cope with the sickness during the initial period of settling in and acclimatisation. Most units were not up to full strength, which increased the burdens on the different staffs.
Training of Medical Personnel in New Caledonia
The training depot for other ranks was attached to the Base Camp Reception Hospital, as at Maadi Camp in Egypt. Field training and instruction in field sanitation were also given to junior medical officers of 4 General Hospital so as to fit them for divisional units. Technicians and medical officers were trained in malaria control and investigation at the American Naval Hospital. Regular clinical meetings, attended by all medical officers in the force, were held fortnightly at 4 General Hospital, where lectures and demonstrations were given. Leading Americans from their hospital staffs attended frequently and often acted as guest speakers. Both hospital and field medical officers thus gained knowledge of tropical diseases and page 30 also kept up their clinical work. In May 1943 a malaria control and tropical hygiene school was established to train the staff of the malaria control unit and unit malaria squads and to spread knowledge of malaria throughout the force. The field units carried out combat training and landing operations in conjunction with their brigades. They learnt the futility of attempting beach landings with the weight of equipment usually carried. New Zealand equipment was felt to compare very unfavourably with that of the United States forces; for example, four United States stretchers weighed only as much as one New Zealand stretcher.
General Medical Arrangements
From the outset the fullest co-operation was extended by the Americans to the ADMS 3 NZ Division (Colonel Twhigg1) and his officers. The American medical organisation in New Caledonia comprised a 750-bed hospital at La Foa, two station hospitals, each of 250 beds, and a medical battalion, their equivalent of three of our field ambulances. There was no convalescent depot, cases being sent to Australia, New Zealand or the United States for long convalescence. The medical battalion was withdrawn from the northern sector prior to the arrival of New Zealand units. Hence it was necessary for the two New Zealand field ambulances to function from the outset. Arrangements were made for 109 American Station Hospital at Kalavere to receive the more seriously ill New Zealand patients until such time as 4 NZ General Hospital could be established.
The undecided composition of the Division – whether it was to have two or three brigades – affected the planning of the medical services. A conference of senior medical officers was held at Headquarters 3 Division on 29 March 1943 to discuss medical requirements for the force in view of the then recently approved expansion. Account was also taken of prospective battle casualties in coming active operations, and the likely incidence of malaria, dysentery, septic sores, mental sickness and other ailments in the Solomon Islands.
1 Brig J. M. Twhigg, DSO, ED, m.i.d.; Wellington; born Dunedin, 13 Sep 1900; physician; CO 5 Fd Amb May 1940-Nov 1941; p.w. Nov 1941; repatriated Apr 1942; ADMS 3 NZ Div Aug 1942-Apr 1943; DDMS 2 NZEF (IP) Apr 1943-Aug 1944; ADMS 2 NZEF (UK) Oct 1944-Feb 1946.
To cope with the estimated requirements of a force of 15,000 engaged in combat duty in a malarious region, it was decided that another unit of similar capacity and type to the CCS would be necessary. Without knowing the future role of the force it was difficult to determine whether this unit should be a 200-bed hospital (expandable) or a 200-bed CCS (expandable). The plan suggested was that the two field surgical units be amalgamated to form the basis of a CCS, that the establishment be brought up to that of a CCS and the balance of necessary equipment provided.
This plan was approved by the DGMS at Army Headquarters in New Zealand, but with the decision in June to limit the Division to two complete brigades of 12,000 men, an extra medical unit was not thought necessary. The choice then lay between sending forward 24 Field Ambulance, which was ready to proceed overseas, and disbanding it and forming the proposed new CCS. A decision was made in favour of using the field ambulance, which with the addition of one or both field surgical units could act as a forward operating unit.
With the opening of 4 General Hospital, the policy in regard to the medical care of New Zealand troops was to utilise New Zealand hospital facilities as far as possible. In cases of urgency, or where the medical officer was of the opinion that road travel would adversely affect the patient, he was admitted to the nearest suitable hospital irrespective of nationality.
In deciding what surgical operations should be performed at field ambulance main dressing stations, with or without field surgical units attached, the policy laid down was that urgent operations should be performed at the MDS, particularly in cases where the time factor or hazards of transport assumed importance. Operations not urgent were carried out in the field units only if in the opinion of the surgeon the cases could be satisfactorily treated under the conditions prevailing, and the patient was not deprived of the advantages of special facilities available at the general hospital.
Medical Headquarters, 2 NZEF (IP)
To meet the requirements of the force as it was constituted by early 1943 a medical headquarters was established at HQ 2 NZEF (IP); it was responsible for administration of the medical services, exclusive of divisional medical services, for co-ordination between United States and New Zealand medical services, for medical supplies, for medical boardings, for evacuation of sick and wounded, page 32 and for medical records and statistics. The United States command was responsible for all transportation from New Zealand to New Caledonia and return, and for all rations, including medical supplies. The Americans evacuated sick and wounded New Zealanders and Americans to New Zealand. The New Zealand Division delivered patients to a given location in New Caledonia and the New Zealand Army took re-delivery at the ship's side at a New Zealand port, usually Auckland.
4 General Hospital
The establishment, as arranged in New Zealand, for 4 General Hospital was for a 600-bed hospital with extra surgical equipment so that a 200-bedded hospital could, if necessary, be budded off from it at any time. In November 1942 Colonel Tennent2 was appointed commanding officer, with Lieutenant-Colonel Comrie3 in charge of the surgical division and Lieutenant-Colonel Sayers4 in charge of the medical division. On account of his pre-war experience as a medical missionary in the Solomons, the last officer was brought back from the Middle East to be consultant in tropical diseases to the Pacific force.
1 Col N. C. Speight, CBE, ED; Dunedin; born Dunedin, 6 Jul 1899; surgeon; medical officer 1 Conv Depot Mar-Nov 1940; CO 6 Fd Amb Jun-Nov 1941; p.w. Nov 1941; repatriated Apr 1942; ADMS 4 Div (NZ) Nov 1942-Mar 1943; ADMS 3 Div Apr 1943-Nov 1944.
2 Col A. A. Tennent, m.i.d.; Wellington; born Timaru, 4 Sep 1899; medical practitioner; 2 i/c 4 Fd Amb Sep 1939-Mar 1940; DADMS 2 NZEF Mar-Dec 1940; CO 1 Conv Depot Dec 1940-Oct 1941; CO 4 Fd Amb Oct-Nov 1941; p.w. Nov 1941; repatriated Apr 1942; ADMS 4 Div (NZ) Aug-Oct 1942; CO 4 Gen Hosp 2 NZEF (IP) Nov 1942-Nov 1943; SMO Sick and Wounded, Army HQ, 1944; ADMS, Central Military District, 1944–45.
3 Lt-Col E. Y. Comrie; Hastings; born Pukekohe, 12 Apr 1900; surgeon; OC Tamavua Hosp Mar-Jun 1942; i/c surgical division 4 Gen Hosp Sep 1942-Jan 1944; CO 2 CCS Jan-May 1944; 3 Gen Hosp Jul-Dec 1944; i/c surgical division 2 Gen Hosp Jan-Nov 1945.
4 Col E.G. Sayers, CMG, Legion of Merit (US); Dunedin; born Christchurch, 10 Sep 1902; physician; medical officer 1 Gen Hosp May 1940; i/c medical division 1 Gen Hosp Aug 1941-Sep 1942; 4 Gen Hosp Oct 1942-Sep 1943; Consultant Physician 2 NZEF (IP) 1943–44; CO 4 Gen Hosp Nov 1943-Aug 1944; Dean of University of Otago Medical School.
5 The huts were built from the stuffed trunks of niaouli trees (eucalyptus) and thatched by the natives with grass or bark. They were used for administrative buildings, cookhouses and kitchens.
During the following months the hospital slowly settled down into a routine, dealing mainly with mild cases of sickness and accidental injuries. High temperatures and high humidity no longer prevailed and the mosquito plague diminished. On 16 July eighty New Zealand WAACs arrived to augment the staff, and allowed some of the orderlies to be released to field units. In August, when the CCS and field ambulances closed prior to moving forward to the Solomon Islands, the number of patients rose to 292, nearly the capacity of the hospital.
Re-location of 4 General Hospital
On 2 July 1943 DDMS 2 NZEF (IP) attended a conference with American senior medical officers to discuss medical arrangements for 2 NZEF (IP) when 3 Division should move forward to a combat zone. In the forward areas would be the divisional units comprising the three field ambulances, the CCS and field surgical units. Base units located in New Caledonia would be 4 General Hospital and 2 Convalescent Depot. As the general policy was to evacuate casualties from the Solomons by hospital ships or other surface craft to Nouméa, it was decided to shift 4 General Hospital to the neighbourhood of this port, from which also patients were evacuated to New Zealand.page 34
A site was selected in Dumbé'a valley, 11 miles from Nouméa, and adjacent to the site being prepared for 8 US General Hospital. Development of the site for the hospital was begun forthwith. At first the hospital was accommodated in tents until the permanent prefabricated wooden wards manufactured in New Zealand were available.
The move of the main body of 4 General Hospital to Dumbé'a valley was completed early in October, and the hospital opened to receive patients on 8 October 1943. A detachment of 150 beds remained at Boguen to provide hospital facilities for troops in the base area until 2 Convalescent Depot opened a hospital at Kalavere. The depot (which had arrived from New Zealand on 24 August and opened temporarily at Roadhouse Houailou) shifted in September to the site vacated by 109 US Hospital at Kalavere in the Moindah area. Here a prefabricated hospital of 150 beds was erected by engineers and was opened on 7 March 1944, when the combined unit became 2 NZ Convalescent Depot and Kalavere Hospital.
At Dumbé'a valley, where it opened on 9 October, 4 General Hospital functioned as a 600-bed hospital equipped on a lavish scale. It was constructed of wooden huts prefabricated in New Zealand and erected by New Zealand engineers. Every building had electric light, hot and cold running water, water closets, a telephone, and, where necessary, steam sterilisation and cooking. A large powerhouse with enormous boilers fired by diesel oil fuel drove a dynamo generating enough electric power to supply the needs of a town of 2000 inhabitants. It was not completed until June 1944. There was water-carried drainage and sewage disposal. The X-ray plant was an elaborate one but was not installed until some time after the hospital opened.
The hospital was not called upon to operate anywhere near capacity, as the limited actions of 3 Division brought few wounded and the sickness rate was kept low, numbers being held and treated at 2 CCS at the advanced base on Guadalcanal. Towards the end of October the first New Zealand battle casualties from 14 Brigade's operations on Vella Lavella were admitted. They had been evacuated by sea and air transport through the CCS to Nouméa harbour or Tontouta airfield, whence they were brought to the hospital by 4 NZ MAC. In November Colonel Sayers succeeded Colonel Tennent as commanding officer. By January 1944 nine of the ten wards had been completed and the detachment from Boguen, along with 1 Army Optician Unit, rejoined its parent unit. In April many medical boards were held and X-ray examinations carried out prior to the troops returning to New Zealand. During May the hospital had the page 35 highest number of patients since its inception – 465. This was largely due to the admission of ankylostomiasis cases from the Division. Two buildings and their contents were extensively damaged by fire in June and July. In July, as the force was being withdrawn to New Zealand, the hospital prepared to close, and by the end of August all the patients and most of the staff had left New Caledonia.
2 NZ Convalescent Depot and Kalavere Hospital
The Convalescent Depot was established on the former 109 US Station Hospital site at Kalavere in September 1943. It was at this time that it was decided to move 4 General Hospital from the nearby Boguen valley, 30 miles away, to Dumbéa valley, and it was arranged that a 150-bed hospital wing be attached to the depot in order to service the surrounding base camps. In the meantime 4 General Hospital maintained a 200-bed hospital at Boguen valley. Provision was made for the addition of 22 NZANS and 39 NZWAACs, as well as 49 orderlies, to the convalescent depot staff. Tents with concrete floors were used as wards but were later replaced by prefabricated huts. Lieutenant-Colonel Wood1 was a very active CO until his sudden death on 13 January 1944, when Lieutenant-Colonel Bennett2 was appointed to command. The number of patients in the depot varied between 100 and 200. It was not until 9 March that the Boguen detachment was closed and Kalavere hospital, which had just been completed on the Convalescent Depot site, then provided the hospital facilities for the base area. At Dumbéa valley 4 General Hospital catered for the casualties from 3 Division in the Solomon Islands, although cases demanding specialist surgical or medical treatment were transferred there from Kalavere. The buildings and facilities at Kalavere were still being extended when arrangements were made from April onwards for the return of part of the Pacific force to New Zealand for employment in essential industry. However, the unit's work did not diminish suddenly as a local outbreak of dengue fever, and ankylostomiasis and other cases transferred from the Solomons, taxed the bed space in June and early July. The unit was closed on 6 August.
Work of 2 Convalescent Depot
2 Lt-Col F. O. Bennett, OBE; Christchurch; born Christchurch, 19 Feb 1899; physician-private, NZMC, 1918–19; 2 i/c 22 Fd Amb (Pacific) Aug 1943-Jan 1944; CO 2 Conv Depot Jan-Jul 1944; SMO Papakura Camp Sep-Dec 1944; OC Tps HS Maunganui Dec 1944-Nov 1945.
By the beginning of December 1943 occupational therapy was well developed, there being a metal workshop, an arts and crafts hut, and a carpenter's workshop. There was also a gardening class. In charge of the occupational therapy was the AEWS officer, who also instituted educational classes.
The medical officers reclassified the patients each week and spent as much time as possible with the convalescents during training hours, making corrections in treatment as required. When the unit was required to run a 150-bed hospital, 22 sisters and 39 WAACs were added to the staff.
The dental services were under the control of the ADDS, NZEF (IP), Lieutenant-Colonel Rout,1 and comprised a camp dental hospital, a dental store, a mobile dental unit and several self-contained dental sections, including two maxillo-facial injury sections. The last two sections were attached to 4 General Hospital and 2 CCS respectively. One dentist was available for every 1500 men in the force. The mobile dental unit of 8 dental officers and 40 other ranks (including 14 ASC drivers) had its own transport, camp equipment and cook, and established permanent camps successively at Moindah and Bouloupari in New Caledonia and at Point Cruz on Guadalcanal. For each officer there was a complete outfit of field dental equipment, so that as many sub-sections as necessary could be detached for service with individual formations in the field. There were one or more on each of the three islands of the Solomons occupied by our troops. The camp dental hospital was established at Base Reception Depot, Tene valley, five miles from Bourail. At first accommodation was in large tents, but later prefabricated tropical huts were made available.page 37
On Guadalcanal a building with a wooden floor was constructed to replace as surgeries the tents with coral-sand floors, but the latter form of accommodation was used on Vella Lavella, Treasury and Nissan.